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Published on: February 28, 2012
Severe Tricuspid Regurgitation in a Patient With a Cardiac Implantable Electronic Device: What We Have Learned
Juan Torrado1, Julio Echarte-Morales2, Matteo Sturla1
1Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
Background:
Cardiac implantable electronic devices (CIEDs) are associated with the occurrence of tricuspid regurgitation (TR) leading to poor outcomes. The distinction between CIED-induced TR and other etiologies is often challenging, making its optimal management difficult.
Clinical Condition:
We describe a case of CIED-induced TR, discuss its common diagnostic/managements challenges, and analyze recent definitions/classifications and position statements.
Key Questions:
What are the most common challenges in diagnosing CIED-induced TR? What are the different causative mechanisms of CIED-inducing TR? How can CIED-induced TR be classified? What are the different management strategies for CIED-induced TR, and what are the main factors to consider?
Outcome:
The patient underwent successful right ventricular lead extraction and placement of a right atrial lead and a coronary sinus lead. Repeat echocardiography showed reversed right ventricular remodeling with improvement of the TR.
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